Sexual problems in couples bring enormous anxiety and frustration and part of the stress they bring is because, in our culture, it can feel shameful to acknowledge the issue.

Thus, a therapist working with a couple’s sexual issues needs to be extremely sensitive while at the same time not shying away from exploring the problem.

Sexual issues in couples have a variety of causes. In some cases there is a genuine medical problem and in others life changes, such as the birth of a baby, will have a major impact on a couple’s sex life.

In many instances psychological issues play a key role. Stress can be a common trigger while, particularly for women, self-image can be an important factor. For example, a woman who has become uncomfortable with her weight may then compare herself to the airbrushed images of women in the media and judge herself unattractive.

In other cases a man or woman may have had their sexuality shamed in some way as a child or young person. They may then have a deep-seated belief that their sexuality if ‘bad’, which will make it difficult to have a satisfying sex life with their partner.

With-holding sex

Also, if a couple are not getting on well in other areas of their lives they are unlikely to be having a good sex life. Sex can also be used as a weapon with, for instance, one of the couple with-holding sex as a conscious or unconscious “punishment” of the other.

The therapist will explore with the couple what the underlying reasons for the sexual problems might be. Often, as soon as a couple starts to get on better in other ways, such as listening to each other more and becoming more accepting, their sex life improves. In the case of one partner with-holding sex because of unspoken resentments, getting them to express their feelings and have them heard by the other can help.

There are also some differences in the way that many men and women experience sexual desire. While it is a generalization there is some truth in the adage that men need to have sex in order to feel loving, while women need to feel loved before wanting sex.

Knowledge can heal

Knowing this can make it easier for a couple to deal with sexual issues. For example, rather than assuming his partner will want to have sex just because he does an aware man will have first spent considerable time making his partner feel cherished.

It is also common, particularly for men, that anxiety about a sexual problem can perpetuate the issue. This is because men’s self-esteem is often closely linked to their sexual “performance”. Thus, a man who experiences erectile dysfunction for a completely understandable reason, such as stress at work, may then become extremely anxious about it happening again. This heightened anxiety makes the problem more likely to re-occur.

A good therapist will be able to work with both members of the couple in reducing their anxiety, which in itself can lead to positive changes. For more complicated issues it may be necessary to explore the couple’s family background and what effect this may have had on attitudes to sex and intimacy.

I am an experienced therapist, seeing individuals and couples. I provide a warm and welcoming space where you can explore difficult issues, so that you can move forward in your life.It can be scary going to see a counsellor or therapist. After all, most of us pride ourselves on our ability to sort out our problems independently. But sometimes things seem to have got to the point where we realise w… Read more